A Screening Approach to the Safe-and-Sustainable-by-Design Development of Advanced Insulation Materials.

Herein, a Safe-and-Sustainable-by-Design (SSbD) screening strategy on four different inorganic aerogel mats and two conventional mineral wools for ranking purposes is demonstrated. Given that they do not consist of particles, the release is first simulated, addressing three occupational exposure scenarios, realistic for their intended use as building insulators. No exposure to consumers nor to the environment is foreseen in the use phase, however, aerosols may be released during mat installation, posing an inhalation risk for workers. All four aerogel mats release more respirable dust than the benchmark materials and 60% thereof deposits in the alveolar region according to modelling tools. The collected aerogel dust allows for subsequent screening of hazard implications via two abiotic assays: 1) surface reactivity in human blood serum; 2) biodissolution kinetics in lung simulant fluids. Both aerogels and conventional insulators show similar surface reactivity. Differences in biodissolution are influenced by the specifically designed organic and inorganic structural modifications. Aerogel mats are better-performing insulators (2-fold lower thermal conductivity than the benchmark) However, this work demonstrates how investment decisions can be balanced with safety and sustainability aspects. Concepts of analogy and similarity thus support easily accessible methods to companies for safe and economically viable innovation with advanced materials.

Home Noninvasive Ventilation in COPD.

Evidence is increasing that long-term noninvasive ventilation (LTNIV) can improve outcomes in individuals with severe, hypercapnic COPD. Although the evidence remains unclear in some aspects, LTNIV seems to be able to improve patient-related and physiologic outcomes like dyspnea, FEV1 and partial pressure of carbon dioxide (Pco2) and also to reduce rehospitalizations and mortality. Efficacy generally is associated with reduction in Pco2. To achieve this, an adequate interface (mask) is essential, as are appropriate ventilation settings that target the specific respiratory physiologic features of COPD. This will ensure comfort, synchrony, and adherence that will result in physiologic improvements. This article briefly reviews the newest evidence and current guidelines on LTNIV in severe COPD. It describes an actual patient who benefitted from the therapy. Finally, it provides strategies for initiating and optimizing this LTNIV in COPD, discussing high-pressure noninvasive ventilation, optimization of triggering, and control of inspiratory time. As demand increases, clinicians will need to be familiar with this therapy to reap its benefits, because inadequately adjusted LTNIV will not be tolerated or effective.

Mortality in individuals with COPD on long-term home non-invasive ventilation.

BACKGROUND: Real-world evidence regarding survival of patients with chronic obstructive pulmonary disease (COPD) using chronic non-invasive ventilation (NIV) is scarce. RESEARCH QUESTION: How do obesity and other factors relate to mortality in patients with COPD on chronic NIV? STUDY DESIGN: and Methods: We retrospectively analyzed data from COPD patients enrolled in a home ventilation program between 2014 and 2018. Survival was compared between obese and non-obese groups using the Kaplan-Meier method. Factors associated with mortality were identified using multivariable Cox proportional regression analyses with Least Absolute Selection and Shrinkage Operator (LASSO) regularization. Univariable analyses were also done stratified by obesity. RESULTS: Median survival was 80.0 (95% CI: 71.0-NA) months among obese (n = 205) and 30.0 (95%CI: 19.0-42.0) months in non-obese (n = 61) patients. NIV adherence was high in both groups. Mortality was associated with male gender [HR 1.44], chronic opioids or benzodiazepines use [HR 1.07], home oxygen use [HR 1.82], fixed pressure mode of ventilation [HR 1.55], NIV inspiratory pressure [HR 1.05], and thoracic cancer [HR 1.27]; obesity [HR: 0.43], age [HR 0.99] and NIV expiratory pressure [HR 0.94] were associated with decreased mortality. In the obese, univariable analyses revealed that chest wall disease, thoracic cancer, home oxygen use, FEV1% predicted, and ventilation parameters were associated with mortality. In the non-obese, male gender and respiratory comorbidities were related to mortality. INTERPRETATION: Obesity is associated with improved survival in COPD patients highly adherent to NIV. Other factors associated with mortality reflect disease severity and ventilator parameters, with differences between obese and non-obese patients.

Alveolar Ventilation-Targeted Versus Spontaneous/Timed Mode for Home Noninvasive Ventilation in Amyotrophic Lateral Sclerosis.

BACKGROUND: Home noninvasive ventilation (NIV) is increasingly used in amyotrophic lateral sclerosis (ALS) to improve symptoms and survival. Our primary objective was to compare intelligent volume-assured pressure support (iVAPS) versus spontaneous/timed (S/T) modes regarding time to first change in ventilator parameters and the number of interventions over 6 months in subjects with ALS in a respiratory therapist (RT)-led program. METHODS: In this study, 30 subjects with ALS meeting criteria for NIV initiation were randomized to iVAPS or S/T. NIV was initiated using standardized protocols targeting optimal tidal volume and comfort in a daytime session. Download data were recorded at 1 week and 1 and 6 months. Any changes in ventilator parameters were recorded. RESULTS: Of the 30 subjects, 56.7% had bulbar onset ALS, 8 died, and 11 in each group completed the study. Median time to first parameter change was 33.5 (interquartile range [IQR] 7.7-96.0) d versus 41.0 (IQR 12.5-216.5) d for iVAPS versus S/T groups, respectively, (P = .48). The average number of RT interventions was similar between groups (1.1 ± 1.1 vs 0.9 ± 0.9 at 1 month, P = .72; 2.4 ± 2.1 vs 2.4 ± 2.3 at 6 months, P = .95, for iVAPS vs S/T, respectively). Adherence was significantly lower with iVAPS than S/T at 1 week but not at 1 or 6 months. Download parameters were similar between groups at 1 week and 6 months except for higher residual apnea-hypopnea index (AHI) and less spontaneously triggered breaths with iVAPS at 6 months. CONCLUSIONS: The time to first change of parameters and the number of interventions at 6 months from NIV initiation were similar for the iVAPS and S/T modes in subjects with ALS. With iVAPS, adherence was lower transiently at NIV initiation, and the residual AHI was higher at 6 months. Alveolar ventilation-targeted NIV may require a longer adaptation period and result in greater upper-airway instability predominantly in patients with bulbar ALS.

Form-Specific and Probabilistic Environmental Risk Assessment of 3 Engineered Nanomaterials (Nano-Ag, Nano-TiO2 , and Nano-ZnO) in European Freshwaters.

The release of engineered nanomaterials (ENMs) to the environment necessitates an assessment of their environmental risks. The currently available environmental risk assessments (ERA) for ENMs are based on an analysis of the total flows of a specific ENM to the environment and on ecotoxicity studies performed with pristine ENMs. It is known that ENMs undergo transformation during product use and release and in technical systems such as wastewater treatment. The aim of the present study was therefore to perform an ERA of 3 ENMs (nano-Ag, nano-TiO2 , and nano-ZnO) based on a form-specific release model and a form-specific analysis of ecotoxicological data. Predicted environmental concentration values were derived using a form-specific material flow model. Species sensitivity distributions were used to derive predicted-no-effect concentrations (PNECs) for the pristine ENMs and for dissolved and transformed Ag and ZnO. For all ENMs, the matrix-embedded form was included in the assessment. A probabilistic assessment was applied, yielding final probability distributions for the risk characterization ratio (RCR). For nano-Ag, the form-specific assessment resulted in a decrease of the mean RCR from 0.061 for the approach neglecting the different release forms to 0.034 because of the much lower PNEC of transformed Ag. Likewise, for nano-ZnO, the form-specific approach reduced the mean RCR from 1.2 to 0.86. For nano-TiO2 , the form-specific assessment did not change the mean RCR of 0.026. This analysis shows that a form-specific approach can have an influence on the assessment of the environmental risks of ENMs and that, given the availability of form-specific release models, an updated ERA for ENMs can be performed. Environ Toxicol Chem 2021;40:2629-2639. © 2021 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Integrated dynamic probabilistic material flow analysis of engineered materials in all European countries.

Uncertainties remain regarding the potential environmental risks of engineered nanomaterials, reflecting missing information on both the exposure and the hazard sides. Probabilistic material flow analysis (PMFA) is a useful exposure assessment tool that maps the flows of a substance through its lifecycle towards the environment, taking into account the uncertainties associated with the input data. In the last years, several refinements have been made to the original PMFA method, increasing its complexity with respect to systems dynamics, fate during recycling and reprocessing and forms of release. In this work, an integrated dynamic probabilistic material flow analysis (IDPMFA) was developed that combines all separate advancements of the method in one overarching software code. The new method was used to assess the forms in which nano-Ag, nano-TiO2 and nano-ZnO are released into air, soils and surface water. Each European country (EU28, Norway and Switzerland) was studied from the year 2000 to the year 2020. The present model includes new assessments of the forms in which nano-ZnO is released into the environment and of the flows out of reprocessing (last step of recycling) of nano-Ag, nano-TiO2 and nano-ZnO towards both technical and environmental compartments. The forms of ZnO released to different compartments vary greatly with different proportions between pristine, dissolved, matrix-embedded and transformed forms. The same applies for the forms of the other ENMs released after reprocessing, where different processes result in very different distributions between the various forms. The country-specific assessment showed that it is mainly the different solid waste treatment schemes that influence the distribution to final environmental sinks. Overall, the results of IDPMFA show the great importance of considering the full life cycle of nanoproducts including the different stages of recycling, the differences between countries, and the forms of the released materials. The results from the integrated model will provide useful input information for environmental fate models and for environmental risk assessments.

Probabilistic environmental risk assessment of microplastics in marine habitats.

Microplastics are ubiquitous in the environment and given the large number of published hazard and exposure studies, quantitative environmental risks assessments of microplastics become feasible. We present here the first environmental risk assessment for marine waters based only on measured concentrations. The Thevariability and uncertainty of the measured data was accounted for in the exposure assessment, while probabilistic species sensitivity distributions were used for hazard assessment, from which a probability distribution was extracted for the predicted no-effect concentration (PNEC). By dividing the exposure distribution by the PNEC-distribution, we were able to calculate probabilistic risk characterisation ratios for each water body in which measurements were performed. Results show a good coverage of the world's major water bodies by measured exposure concentrations (MECs), while the hazard assessment could be improved by aligning the type of particles tested in hazard studies (size, form, polymer) to those actually found in the oceans. Overall, the mean predicted no-effect concentration (PNEC) is 3.84·106 part m-3, with Oryzias melastigma being the most sensitive species (calculated mean NOEC of 3.90·106 part m-3). Interestingly, the only type of dose descriptor that could be extracted from the literature for particles above 10-20 µm was the highest observed no effect concentration (HONEC), which indicates a very low or null toxicity of these larger MPs towards marine organisms. The mean MEC is 1.5·103 part m-3, the highest concentrations being measured in the Atlantic and Pacific Ocean. Although there is a very small overlap of the probability distribution associated with the RCR (0.00002 % of the data points), the mean RCR is 4·10-4 and therefore risks are unlikely given the available data. However, as increasing amounts of plastic reach the environment, RCRs can be expected to increase in the future.

Noninvasive Ventilation Downloads and Monitoring.

"Home noninvasive ventilation (NIV) is indicated for numerous conditions including neuromuscular disease, thoracic cage disorders, chronic obstructive pulmonary disease, and hypoventilation syndromes. Effective management of patients on home NIV requires clinicians to interpret data downloads from NIV devices. Clinicians must first look at adherence and factors that may impact this including mask comfort and fit. Next, leak assessment is undertaken. Once these are addressed, such information as apnea-hypopnea index, exhaled tidal volume, and percent triggered breaths help clinicians troubleshoot setting changes. Finally, overnight oximetry and transcutaneous CO2 monitoring are useful adjuncts to the data download to optimize NIV settings."

Dynamic probabilistic material flow analysis of engineered nanomaterials in European waste treatment systems.

Knowledge on the material flows of engineered nanomaterials (ENMs) is crucial for assessing their environmental risks. Waste management processes constitute important parts of material flow analyses as they affect large fractions of the ENMs. Accordingly, their detailed representation could substantially improve the models. Our goal was to consider the temporal variations of wastewater and solid waste management in the dynamic probabilistic material flow analysis of carbon nanotubes (CNTs), nano-Ag, -TiO2 and -ZnO in Europe from 2000 to 2020. New input parameters included wastewater and solid waste management rates for each year. The uncertainties associated with these data were assessed based on the type of consulted source, the geographical representativeness and temporal concordance. Results show modal values of 10-27% of ENMs going from sorting to reprocessing. Large shares of environmental releases of nano-Ag and nano-ZnO end in surface water (4.9 t and 1700 t respectively in 2020), while sludge-treated soil as environmental compartment is receiving most of nano-TiO2 (22,000 t in 2020) and CNTs (8.8 t in 2020). Discharges from wastewater management to the subsurface soil make this compartment the largest environmental sink of nano-Ag and nano-ZnO (30 t and 3860 t accumulated in 2020, respectively). Landfills represent significant stocks of ENMs, with 105 t, 2077 t, 69,000 t and 1042 t of nano-Ag, nano-ZnO, nano-TiO2 and CNTs. This model includes detailed descriptions of waste management and sources of ENMs released at the European scale. However, a better understanding of the behaviour, i.e. fate and potential transformations of ENMs in reprocessing systems, is needed to complete the full assessment.

Systematic Consideration of Parameter Uncertainty and Variability in Probabilistic Species Sensitivity Distributions.

The calculation of a species sensitivity distribution (SSD) is a commonly accepted approach to derive the predicted no-effect concentration (PNEC) of a substance in the context of environmental risk assessment. The SSD approach usually is data demanding and incorporates a large number of ecotoxicological values from different experimental studies. The probabilistic SSD (PSSD) approach is able to fully consider the variability between different exposure conditions and material types, which is of great importance when constructing an SSD for any chemical, especially for nanomaterials. The aim of our work was to further develop the PSSD approach by implementing methods to better consider the uncertainty and variability of the input data. We incorporated probabilistic elements to consider the uncertainty associated with uncertainty factors by using probability distributions instead of single values. The new PSSD method (named "PSSD+") computes 10 000 PSSDs based on a Monte Carlo routine. For each PSSD calculated, the hazardous concentration for 5% of species (HC5 ) was extracted to provide a PNEC distribution based on all data available and their associated uncertainty. The PSSD+ approach also includes the option to consider a species weighting according to a typically constituted biome. We applied this PSSD+ approach to a previously published data set on C nanotubes and Ag nanoparticles. The evaluation of the uncertainty factor distributions and species weighting have shown that the proposed PSSD method is robust with respect to the calculation of the PNEC value. Furthermore, we demonstrated that the PSSD+ can handle both small and more comprehensive data sets because the PNEC distributions are a close representation of the data available. Finally, the sensitivity testing toward data set variations showed that the maximum variation of the mean PNEC was of a factor of about 2, so that the method is relatively insensitive to missing data points as long as the most sensitive species is included. Integr Environ Assess Manag 2020;16:211-222. © 2019 SETAC.

Toward an ecotoxicological risk assessment of microplastics: Comparison of available hazard and exposure data in freshwaters.

Microplastics have been detected in freshwaters all over the world in almost all samples, and ecotoxicological studies have shown adverse effects of microplastics on organisms. However, no risk assessment of microplastics has been performed specifically in freshwater so far. The aim of the present study was therefore to review all exposure and ecotoxicity data available for microplastics in freshwaters and to perform a preliminary probabilistic risk assessment. The exposure probability distribution was based on 391 concentrations measured in Asia, Europe, and North America. Because exposure data are mainly available in particle number-based metrics but results from hazard studies are mostly mass-based, the hazard results were converted into particle number concentrations. A statistical analysis of the hazard data showed that there was no significant influence of particle shape or type of polymer on the no-observed-effect concentration. The predicted-no-effect concentration (PNEC) was calculated as the fifth percentile of the probabilistic species sensitivity distribution, based on 53 values from 14 freshwater species, to have a mode of 7.4 × 105 particles · m-3 (25th and 75th quantiles of 6.1 × 105 and 1.3 × 106 particles · m-3 , respectively). The exposure probability distribution was divided by the PNEC probability distribution to calculate risk characterization ratios (RCRs), with modes of 1.3 × 10-6 in North America, 3.3 × 10-6 in Europe, and 4.6 × 10-3 in Asia. Probability distributions associated with the RCRs showed that ecological risks cannot be entirely excluded in Asia, where 0.4% of the RCR values were above 1. Environ Toxicol Chem 2019;38:436-447. © 2018 SETAC.

Considering the forms of released engineered nanomaterials in probabilistic material flow analysis.

Most existing models for assessing the releases of engineered nanomaterials (ENMs) into the environment are based on the assumption that ENMs remain in their pristine forms during their whole life cycle. It is known, however, that this is not always the case as ENMs are often embedded into solid matrices during manufacturing and can undergo physical or chemical transformations during their life cycle, e.g. upon release to wastewater. In this work, we present a method for systematically assessing the forms in which nano-Ag and nano-TiO2 flow through their life cycle (i.e. production, manufacturing, use and disposal) to their points of release to air, soil and surface water. Input data on the forms of released ENMs were probability distributions based on peer-reviewed literature. Release data were incorporated into a probabilistic material flow analysis model to quantify the proportions of ENMs in product-embedded, matrix-embedded, pristine, transformed and dissolved forms in all technical and environmental compartments into which they flow, at the European scale. Releases of nano-Ag to surface water and soil were modelled to occur primarily in transformed forms (Q25 and Q75 of 34-58% and 78-86%, respectively, with means of 53% and 82%), while releases to air were mostly in pristine and matrix-embedded forms (38-46% and 36-44%, respectively, with means of 42% and 40%). In contrast, nano-TiO2 releases to air, soil and water were estimated to be predominantly in pristine form (75-85%, 90-95%, 96-98%, respectively, with means of 80%, 91% and 97%). The distributions of ENM releases between forms developed here will improve the representativeness and appropriateness of input data for environmental fate modelling and risk assessment of ENMs.

Characterization of engineered TiO2 nanomaterials in a life cycle and risk assessments perspective.

For the last 10 years, engineered nanomaterials (ENMs) have raised interest to industrials due to their properties. They are present in a large variety of products from cosmetics to building materials through food additives, and their value on the market was estimated to reach $3 trillion in 2014 (Technology Strategy Board 2009). TiO2 NMs represent the second most important part of ENMs production worldwide (550-5500 t/year). However, a gap of knowledge remains regarding the fate and the effects of these, and consequently, impact and risk assessments are challenging. This is due to difficulties in not only characterizing NMs but also in selecting the NM properties which could contribute most to ecotoxicity and human toxicity. Characterizing NMs should thus rely on various analytical techniques in order to evaluate several properties and to crosscheck the results. The aims of this review are to understand the fate and effects of TiO2 NMs in water, sediment, and soil and to determine which of their properties need to be characterized, to assess the analytical techniques available for their characterization, and to discuss the integration of specific properties in the Life Cycle Assessment and Risk Assessment calculations. This study underlines the need to take into account nano-specific properties in the modeling of their fate and effects. Among them, crystallinity, size, aggregation state, surface area, and particle number are most significant. This highlights the need for adapting ecotoxicological studies to NP-specific properties via new methods of measurement and new metrics for ecotoxicity thresholds.

Terrestrial and aquatic ecotoxicity assessment of Cr(VI) by the ReCiPe method calculation (LCIA): application on an old industrial contaminated site.

The most stable forms of chromium in the environment are chromium (III) and chromium (VI), the former being relatively immobile and necessary for organisms, and the latter being highly soluble and toxic. It is thus important to characterise ecotoxicological impacts of Cr(VI). However, there are still some important uncertainties in the calculation of ecotoxicological impacts of heavy metals in the LCIA global approach. The aim of this paper is to understand how the spatial and dynamic characterization of life cycle inventory (LCI) data can be exploited in life cycle impact assessment and particularly for the evaluation of the aquatic and terrestrial ecotoxicity of Cr(VI). To quantify these impacts, we studied an industrial waste landfill in the North of France that was contaminated with chromium. On the polluted area, the aquatic contamination is due to the slag heap as well as to chromium spots in soil. The soil contamination is mainly due to infiltration of chromium from the infill. The concentration of Cr(VI) in soil and water varies according to seasonal climatic variations and groundwater level. These variations have an effect on the Cr(VI) fate factor, in particular on transfer and residence time of the substance. This study underlines the spatial distribution of aquatic ecotoxicity and the temporal variation of freshwater ecotoxicity. We analysed the correlation between precipitation, temperature, concentration and ecotoxicity impact. With regards to the terrestrial ecotoxicity, the study focused on the vertical variation of the ecotoxicity and the major role of the soil layer composition into terrestrial pollution.